Effectiveness of progressive tendon-loading exercise therapy in patients with patellar tendinopathy:a randomised clinical trial

Objective To compare the effectiveness of progressive tendon-loading exercises (PTLE) with eccentric exercise therapy (EET) in patients with patellar tendinopathy (PT). Methods In a stratified, investigator-blinded, block-randomised trial, 76 patients with clinically diagnosed and ultrasound-confirmed PT were randomly assigned in a 1:1 ratio to receive either PTLE or EET. The primary end point was clinical outcome after 24 weeks following an intention-to-treat analysis, as assessed with the validated Victorian Institute of Sports Assessment for patellar tendons (VISA-P) questionnaire measuring pain, function and ability to play sports. Secondary outcomes included the return to sports rate, subjective patient satisfaction and exercise adherence. Results Patients were randomised between January 2017 and July 2019. The intention-to-treat population (mean age, 24 years, SD 4); 58 (76%) male) consisted of patients with mostly chronic PT (median symptom duration 2 years). Most patients (82%) underwent prior treatment for PT but failed to recover fully. 38 patients were randomised to the PTLE group and 38 patients to the EET group. The improvement in VISA-P score was significantly better for PTLE than for EET after 24 weeks (28 vs 18 points, adjusted mean between-group difference, 9 (95% CI 1 to 16); p=0.023). There was a trend towards a higher return to sports rate in the PTLE group (43% vs 27%, p=0.13). No significant between-group difference was found for subjective patient satisfaction (81% vs 83%, p=0.54) and exercise adherence between the PTLE group and EET group after 24 weeks (40% vs 49%, p=0.33). Conclusions In patients with PT, PTLE resulted in a significantly better clinical outcome after 24 weeks than EET. PTLE are superior to EET and are therefore recommended as initial conservative treatment for PT

Qualitative flow metabolic phenotype of pancreatic cancer: a new prognostic biomarker?

Background Retrospective analysis to investigate the relationship between the flow-metabolic phenotype and overall survival (OS) of pancreatic ductal adenocarcinoma (PDAC) and its potential clinical utility. Methods Patients with histopathologically proven PDAC between 2005 and 2014 using tumor attenuation on routine pre-operative CECT as a surrogate for the vascularity and [18F]FDG-uptake as a surrogate for metabolic activity on [18F]FDG-PET. Results In total, 93 patients (50 male, 43 female, median age 63) were included. Hypoattenuating PDAC with high [18F]FDG-uptake has the poorest prognosis (median OS 7 ± 1 months), compared to hypoattenuating PDAC with low [18F]FDG-uptake (median OS 11 ± 3 months; p = 0.176), iso- or hyperattenuating PDAC with high [18F]FDG-uptake (median OS 15 ± 5 months; p = 0.004) and iso- or hyperattenuating PDAC with low [18F]FDG-uptake (median OS 23 ± 4 months; p = 0.035). In multivariate analysis, surgery combined with tumor differentiation, tumor stage, systemic therapy and flow metabolic phenotype remained independent predictors for overall survival. Discussion The novel qualitative flow-metabolic phenotype of PDAC using a combination of CECT and [18F]FDG-PET features, predicted significantly worse survival for hypoattenuating-high uptake pancreatic cancers compared to the other phenotypes

Analysis of hybrid mode-locking of two-section quantum dot lasers operating at 1.5 micron

For the first time a detailed study of hybrid mode-locking in two- section InAs/InP quantum dot Fabry-Pérot-type lasers is presented. The output pulses have a typical upchirp of approximately 8 ps/nm, leading to very elongated pulses. The mechanism leading to this typical pulse shape and the phase noise is investigated by detailed radio-frequency and optical spectral studies as well as time-domain studies. The pulse shaping mechanism in these lasers is found to be fundamentally different than the mechanism observed in conventional mode-locked laser diodes, based on quantum well gain or bulk material. ©2009 Optical Society of America

Randomized Clinical Trial of Laparoscopic Versus Open Repair of the Perforated Peptic Ulcer: The LAMA Trial

Background: Laparoscopic surgery has become popular during the last decade, mainly because it is associated with fewer postoperative complications than the conventional open appr

Gain measurements of Fabry-Perot InP/InGaAsP lasers using an ultra high resolution spectrometer

In this paper we present the use of an ultra-high resolution (20 MHz) spectrometer to measure the gain in a Fabry-Pérot InGaAsP laser from subthreshold ASE spectra. The method is derived from the Hakki-Paoli method. A non-linear least-squares fitting of the observed modes is used to extract the gain from the line shape. Each mode of the measured spectrum is fully resolved and fitted separately. Thus the spectral gain curve is not restricted to a parabolic function. The optical gain spectrum and the differential gain are determined. These parameters will be used in our laser simulations

Photonic integrated circuits: where are the limits?

The integration scale in Photonic Integrated Circuits will be pushed to VLSI-level in the coming decade. Key technologies for reduction of device dimensions are high resolution lithography and deep waveguide etching technology. In this paper developments in Photonic Integration are reviewed and the limits for reduction of device dimensions are discussed

Observation of Q-switching and mode-locking in two-section InAs/InP (100) quantum dod lasers around 1.55 μm

For the first time passive mode-locking in two-section quantum-dot lasers operating at wavelengths around 1.55 µm is reported. Pulse generation at 4.6 GHz from a 9-mm long device is verified by background-free autocorrelation, RF-spectra and real-time oscilloscope traces. The output pulses have a 7 nm optical bandwidth and are stretched in time and heavily up-chirped with a value of 20 ps/nm. From a 7 mm long device Q-switching is observed over a large operating regime. The lasers have been realized using a fabrication technology that is compatible with further photonic integration, and can perform the function of e.g. a mode-comb generator